Ankle Orthopaedic Test: Impingement sign ankle

The Impingement sign ankle test is a physical examination technique used to diagnose ankle impingement syndrome. Ankle impingement syndrome occurs when soft tissue or bony structures in the ankle joint become compressed, resulting in pain and limited mobility. This condition is common in athletes, particularly those involved in sports that require repetitive jumping or cutting movements.

Here are the steps to perform the impingement sign:

1. Have the patient sit on the examination table with their legs hanging over the edge.

2. Grasp the patient's foot with one hand and their heel with the other hand.

3. With your thumbs, apply pressure to the front and back of the ankle joint, just above the ankle bones.

4. Ask the patient to move their foot up and down, or dorsiflex and plantarflex the foot.

5. Observe the patient's face for any signs of pain or discomfort.

6. Repeat the test with the foot turned inward, or inverted, and then outward, or everted.

If the patient experiences pain or discomfort when pressure is applied to the front or back of the ankle joint during movement, this may indicate impingement of the joint. However, it is important to note that the impingement sign should be used in conjunction with other examination techniques and diagnostic tests to accurately diagnose ankle injuries.

References:

1. Molloy A, Wood EV. Impingement syndromes of the ankle. Foot Ankle Clin. 2014 Dec;19(4):579-95. doi: 10.1016/j.fcl.2014.08.009. PMID: 25456760.
2. Kim HN, Jeong YM, Lee JH, Kim HJ, Ahn JH, Lee WC. Impingement sign: a new clinical test for diagnosing anterior ankle impingement syndrome. Foot Ankle Int. 2012 Feb;33(2):126-30. doi: 10.3113/FAI.2012.0126. PMID: 22381457.
3. Baker CL 3rd, Feller JA, Hewitt M, Hopkins JT, Richenberg J, Anderson K. The anterior impingement syndrome of the ankle. Am J Sports Med. 2003 May-Jun;31(3):469-80. doi: 10.1177/03635465030310032401. PMID: 12750102.
4. Saxena A, Fullem B, Hannaford D. Results of a prospective study on the effectiveness of a modified impingement test for diagnosis of anterior ankle impingement syndrome. J Foot Ankle Surg. 2007 May-Jun;46(3):173-7. doi: 10.1053/j.jfas.2007.01.004. PMID: 17478252.
5. Scholten PE, Tuinebreijer WE, Krips R, van Dijk CN. The ankle impingement test: a reliability study. Knee Surg Sports Traumatol Arthrosc. 2009 Jun;17(6):700-5. doi: 10.1007/s00167-009-0788-1. Epub 2009 Mar 3. PMID: 19255886.